Common use of Provision of Insurance Clause in Contracts

Provision of Insurance. If traveling out of the United States with South Texas Children’s Home Ministries, it is the responsibility of the Applicant to verify with his/her own insurance provider that the benefits will cover out-of-country services. Insurance Provider: Primary Policy Holder: Policy/Identification #: Group #: In the event the Applicant is less than 18 years of age at the time of the anticipated trip, or is otherwise legally incapacitated or disabled (consult counsel if you are unsure of this), it is absolutely necessary for the parent/guardian to sign this portion of the agreement. If the Applicant is 18 years of age or older and is legally capable, he/she must sign the consent for medical treatment for himself/herself. Medical Release for MINOR (17 years of age or younger or otherwise incapacitated or disabled): I hereby give to (name of individual in charge of group) permission to authorize whatever medical treatment may be necessary in the case of (name of participant) I will not hold (name of individual in charge of group) or anyone connected with South Texas Children’s Home Ministries responsible in case of adverse results or problems that arise from such treatment. Signature – Parent/Guardian Date Medical Release for ADULT (18 years of age or older): I hereby give to (name of individual in charge of group) permission to authorize whatever medical treatment may be necessary for me,